—Pennsylvania’s State-based Health Insurance Marketplace PA’s Replacement for

Updated on August 27, 2023
Health Insurance Concept - Doctor in hospital with health insurance related icon graphic interface showing healthcare people, money planning, risk management, medical treatment and coverage benefit.

The Southwestern PA Registered Nurses Club recently hosted Scott Yeager, Outreach Manager of Pennie®, the Pennsylvania Health Insurance Exchange Authority. The responses from the 70+ nurses who attended ranged from, “I have family members and friends who may benefit from this”, to “I am happy to learn about this option for my patients”. 

Pennie is Pennsylvania’s official replacement for the federal government’s healthcare marketplace for health and dental insurance. Pennie provides financial assistance to help customers reduce the cost of coverage and care, depending on the person’s earnings on their tax return. (Welcome to Pennie

Pennie uses the federal poverty level as the starting point and determines how much financial assistance to give to help cover the person’s healthcare. This is called an advanced premium tax credit (APTC), which is a tax credit that lowers your premium, meaning that your monthly health insurance payment can be much lower than it is currently. Nine of ten current Pennie customers qualify for financial assistance at all income levels. 

As a state-based marketplace, Pennie created a new Qualifying Life Event to help Pennsylvanians with an annual household income equal to or below 150% of the federal poverty level – throughout the year, including outside of Open Enrollment, Pennsylvanians at or below 150% of the federal poverty level who otherwise do not qualify for Medical Assistance or some other form of health/dental coverage can enroll in or change their plan through Pennie.

Example Incomes at 150% FPL* :
Household / Family Size Annual Income
Single $19,320
2-person $26,130
3-person $32,940
4-person $39,750

Pennie has Pennie-Certified Assisters who will answer questions about Pennie, and they are located nearby to the person who calls in with questions. 

If the Pennsylvania resident qualifies for Pennie financial assistance and is interested in buying health insurance through Pennie, there are Pennie-Certified Insurance Brokers who will help find the best plan. 

Here is the link for both of these Pennie helpers

Pennie works in concert with Medical Assistance (Medicaid) so that if a person fills out a Pennie application but their income level qualifies them for Medicaid instead, they don’t have to go through the entire process again. And, this occurs in reverse also. 

Pennie’s Open Enrollment Period runs from November 1 to January 15 with December 15 being the deadline for coverage that begins January 1st. But don’t wait to enroll – although December 15th marks the deadline for coverage that begins January 1, 2023, you can still enroll through January 15th to begin coverage on February 1, 2023.

Mary A. O’Connor, PhD, MSN, RN, is President of SWPA RN Club.

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Mary O'Connor, PhD, MSN, RN
Professor Emeritus, PennWest University, California campus
Pennsylvania Organization of Nurse Leaders (PONL), Legislative Committee